Review article http://dx.doi.org/10.6065/apem.2015.20.3.125 Ann Pediatr Endocrinol Metab 2015;20:125-129
Body mass index and body composition scaling to height in children and adolescent Sochung Chung, MD, PhD Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
Childhood obesity prevalence has been increased and known to be related to various diseases and mortality in adult and body mass index (BMI) has been widely used as a screening tool in children with obesity. It is important to understand what BMI is and its limitations. BMI is a measure of weight adjusted for height. Weight scales to height with a power of about 2, is the basis of BMI (weight/height2) as the scaling of body weight to height across adults provides powers rounded to 2. BMI has the advantage of a simple and noninvasive surrogate measure of body fat, but it has limitation in differentiating body fat from lean (fat free) mass and low-moderate sensitivity is problematic for clinical applications. Among overweight children higher BMI levels can be a result of increased either fat or fat-free mass. BMI could be divided into fat-free mass index and fat mass index. Monitoring of the changes in body composition is important as distinguishing changes in each component occur with rapid growth in adolescents as it is occur in concert with changes in the hormonal environment. Reference values for each body composition indexes and chart created with selected percentiles of a normal adolescent population could be helpful in growth assessment and health risk evaluation. Keywords: Growth, Obesity, Body mass index, Body composition, child
Introduction The obesity prevalence in children and adolescents has been increased along with the change of socioeconomic environment and pattern of lifestyle1-3). Obesity in children was assumed to be associated with the risk of adult obesity and the other diseases, such as type 2 diabetes mellitus or cardiovascular diseases. Body mass index (BMI) has been considered as an indicator of body fatness and widely used as a screening method of obesity as it is well known index to predict fatness and health risk assessment. Elevated BMI in childhood is related to adult obesity4) and high risk of various disease such as diabetes, atherosclerosis and total mortality5,6). Received: September, 2015 Accepted: September, 2015 Address for correspondence: Sochung Chung, MD, PhD Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: +82-2-2030-7553 Fax: +82-2-2030-7748 E-mail: [email protected]
What is BMI and weight for height It is important to understand what BMI is and its limitations in clinical practice and public health research, especially in children and adolescent. Although BMI has the advantage of a noninvasive and simple surrogate of body fat, it has limitation in differentiating body fat from lean mass. BMI calculated as weight in kilograms divided by the square of height in meters (kg/ m2), is a measure of weight adjusted for height, as the scaling of body weight to height across adults provides powers rounded to 27-9). Certain conditions can influence the interpretation of BMI such as athletes, may have a high
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
©2015 Annals of Pediatric Endocrinology & Metabolism
ISSN: 2287-1012(Print) ISSN: 2287-1292(Online)
Chung S • BMI and body composition index in children
BMI because of increased muscle mass. Changing relationship between height and weight with age complicated the situation. Women have high percent body fat than men with an similar BMI, older adults tend to have more fat than younger adults for an similar BMI10,11). For children, BMI is calculated the same way as in adult, but the results of BMI are interpreted differently, should be relative to a child’s age and gender. As other factors such as height difference and level of secondary sexual maturation, the relationship between BMI and body fat among children and body fat amount changes with age and varies by gender. BMI rises rapidly from birth to age 2 years then declines until age 5-6 years. After adiposity rebound–when BMI increase again, it increases throughout childhood and adolescence.
BMI for age and growth chart references BMI for age is the indicator for relative position of the child’s BMI value among children of the same age and gender. Percentiles specific to age and sex classify underweight (
Body mass index and body composition scaling to height in children and adolescent Sochung Chung, MD, PhD Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
Childhood obesity prevalence has been increased and known to be related to various diseases and mortality in adult and body mass index (BMI) has been widely used as a screening tool in children with obesity. It is important to understand what BMI is and its limitations. BMI is a measure of weight adjusted for height. Weight scales to height with a power of about 2, is the basis of BMI (weight/height2) as the scaling of body weight to height across adults provides powers rounded to 2. BMI has the advantage of a simple and noninvasive surrogate measure of body fat, but it has limitation in differentiating body fat from lean (fat free) mass and low-moderate sensitivity is problematic for clinical applications. Among overweight children higher BMI levels can be a result of increased either fat or fat-free mass. BMI could be divided into fat-free mass index and fat mass index. Monitoring of the changes in body composition is important as distinguishing changes in each component occur with rapid growth in adolescents as it is occur in concert with changes in the hormonal environment. Reference values for each body composition indexes and chart created with selected percentiles of a normal adolescent population could be helpful in growth assessment and health risk evaluation. Keywords: Growth, Obesity, Body mass index, Body composition, child
Introduction The obesity prevalence in children and adolescents has been increased along with the change of socioeconomic environment and pattern of lifestyle1-3). Obesity in children was assumed to be associated with the risk of adult obesity and the other diseases, such as type 2 diabetes mellitus or cardiovascular diseases. Body mass index (BMI) has been considered as an indicator of body fatness and widely used as a screening method of obesity as it is well known index to predict fatness and health risk assessment. Elevated BMI in childhood is related to adult obesity4) and high risk of various disease such as diabetes, atherosclerosis and total mortality5,6). Received: September, 2015 Accepted: September, 2015 Address for correspondence: Sochung Chung, MD, PhD Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: +82-2-2030-7553 Fax: +82-2-2030-7748 E-mail: [email protected]
What is BMI and weight for height It is important to understand what BMI is and its limitations in clinical practice and public health research, especially in children and adolescent. Although BMI has the advantage of a noninvasive and simple surrogate of body fat, it has limitation in differentiating body fat from lean mass. BMI calculated as weight in kilograms divided by the square of height in meters (kg/ m2), is a measure of weight adjusted for height, as the scaling of body weight to height across adults provides powers rounded to 27-9). Certain conditions can influence the interpretation of BMI such as athletes, may have a high
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
©2015 Annals of Pediatric Endocrinology & Metabolism
ISSN: 2287-1012(Print) ISSN: 2287-1292(Online)
Chung S • BMI and body composition index in children
BMI because of increased muscle mass. Changing relationship between height and weight with age complicated the situation. Women have high percent body fat than men with an similar BMI, older adults tend to have more fat than younger adults for an similar BMI10,11). For children, BMI is calculated the same way as in adult, but the results of BMI are interpreted differently, should be relative to a child’s age and gender. As other factors such as height difference and level of secondary sexual maturation, the relationship between BMI and body fat among children and body fat amount changes with age and varies by gender. BMI rises rapidly from birth to age 2 years then declines until age 5-6 years. After adiposity rebound–when BMI increase again, it increases throughout childhood and adolescence.
BMI for age and growth chart references BMI for age is the indicator for relative position of the child’s BMI value among children of the same age and gender. Percentiles specific to age and sex classify underweight (
